Eletrólitos séricos e prognóstico em doentes submetidos a gastrostomia endoscópica / Serum electrolytes and outcome in patients undergoing endoscopic gastrostomy

ABSTRACT BACKGROUND: Percutaneous endoscopic gastrostomy (PEG) is a gold standard for long term enteral feeding. Neurologic dysphagia and head/neck cancer are the most common indications for PEG as they can lead to protein-energy malnutrition and serum electrolyte abnormalities, with potential negative impact on metabolic balance. Refeeding syndrome may also be related with severe electrolyte changes in PEG-fed patients and contribute to poor prognosis. OBJECTIVE: This study aims to evaluate the changes in serum concentrations of the main electrolytes and its possible association with the outcome. METHODS: Retrospective study of patients followed in our Artificial Nutrition Clinic, submitted to PEG from 2010 to 2016, having head/neck cancer or neurologic dysphagia, who died under PEG feeding. Serum electrolytes (sodium, potassium, chlorine, magnesium, calcium and phosphorus) were evaluated immediately before the gastrostomy procedure. Survival after PEG until death was recorded in months. RESULTS: We evaluated 101 patients, 59 with electrolyte alterations at the moment of the gastrostomy. Sodium was altered in 32 (31.7%), magnesium in 21 (20.8%), chlorine in 21 (20.8%), potassium in 14 (13.8%), calcium in 11 (10.9 %) and phosphorus in 11 (10.9%). The survival of patients with low sodium (<135 mmol/L) was significantly lower when compared to patients with normal/high values, 2.76 months vs 7.80 months, respectively (P=0.007). CONCLUSION: Changes in serum electrolytes of patients undergoing PEG were very common. More than half showed at least one abnormality, at the time of the procedure. The most frequent was hyponatremia, which was associated with significantly shorter survival, probably reflecting severe systemic metabolic distress.

RESUMO CONTEXTO: A gastrostomia endoscópica percutânea (PEG) é a via de eleição preferencial para a nutrição entérica de longa duração. A disfagia neurológica e as neoplasias cervico-faciais constituem as principais indicações para PEG por poderem conduzir a desnutrição energético-proteica e alterações hidroeletrolíticas, com potencial impacto negativo no equilíbrio metabólico. A síndrome de realimentação pode também estar associada a alterações hidroeletrolíticas graves em doentes alimentados por PEG e contribuir para um mau prognóstico. OBJETIVO: Avaliar as alterações das concentrações séricas dos principais eletrólitos e a eventual associação entre os valores séricos alterados e o prognóstico dos doentes gastrostomizados. Métodos - Estudo retrospetivo realizado em doentes seguidos na Consulta de Nutrição Artificial do Hospital Garcia de Orta, propostos e submetidos a PEG, de 2010 a 2016 e que faleceram sob nutrição por PEG. Consideraram-se os valores séricos dos iões em estudo avaliados imediatamente antes do procedimento endoscópico de gastrostomia, obtidos por consulta do processo clínico. A sobrevida, após a realização da PEG até à morte foi registrada em meses. RESULTADOS: Avaliaram-se 101 doentes. A sobrevida média pós-gastrostomia foi 6,55 meses. Destes, 59 apresentaram alterações de alguns iões no momento da realização da PEG. O sódio estava alterado em 31 (30,6%), magnésio em 20 (19,8%), cloro em 19 (18,8%), potássio em 14 (13,8%), cálcio em 10 (9,9%) e o fósforo em 9 (8,9%). Quando comparada a sobrevida dos doentes com valores de sódio baixo (<135 mmol/L) com a dos doentes com valores normais/elevados, esta foi 2,76 meses vs 7,80 meses, respectivamente (P=0,007). CONCLUSÃO: As alterações dos eletrólitos séricos nos doentes submetidos a PEG foram muito frequentes, com mais de metade dos doentes a apresentarem pelo menos uma alteração aquando da realização do procedimento. A alteração mais frequente foi a hiponatrémia, associando-se a pior prognóstico com sobrevida significativamente mais curta, refletindo provavelmente um grave compromisso metabólico sistêmico.

Excess fluid volume: sociodemographic and clinical analysis in haemodialysis patients / Excesso de volume de líquidos: análise clínica e sociodemográfica em pacientes de hemodiálise / El exceso de volumen de líquido: el análisis sociodemográfico y clínico en pacientes en hemodiálisis

ABSTRACT Objective: To analyse the defining characteristics and related factors in the nursing diagnosis Excess fluid volume and its relationship to sociodemographic and clinical variables in haemodialysis patients. Method: Cross-sectional study, conducted using a form and physical examination, with a sample of 100 patients, between December 2012 and April 2013 at a university hospital and a dialysis clinic. Results: It was found 10 significant statistical associations between the defining characteristics/ related factors of Excess fluid volume and the sociodemographic and clinical variables. Conclusion: The defining characteristics and related factors of Excess fluid volume could be influenced by sociodemographic and clinical variables in haemodialysis clientele.

RESUMO Objetivo: analisar as características definidoras e fatores relacionados ao diagnóstico de enfermagem excesso de volume de líquidos e sua relação com variáveis clínicas e sociodemográficas em pacientes em hemodiálise. Método: estudo transversal, desenvolvido com a utilização de um formulário e exame físico, com uma amostra de 100 pacientes, entre dezembro 2012 e abril 2013 em um hospital universitário e uma clínica de diálise. Resultados: dez associações estatisticamente significantes foram encontradas entre as características definidoras/fatores relacionadas ao excesso de volume de líquidos e as variáveis clínicas e sociodemográficas. Conclusão: as características definidoras e fatores relacionados ao excesso de volume de líquidos podem ser influenciados por variáveis clínicas e sociodemográficas em pacientes em hemodiálise.

RESUMEN Objetivo: analizar las características definitorias y los factores relacionados con el diagnóstico enfermero de exceso de volumen líquido y su relación con variables sociodemográficas y clínicas en pacientes de hemodiálisis. Método: estudio transversal, realizado mediante un formulario y examen físico, con una muestra de 100 pacientes, entre diciembre de 2012 y abril de 2013 en un hospital universitario y una clínica de diálisis. Resultados: se encontraron 10 asociaciones estadísticamente significativas entre las características definitorias, factores relacionados de volumen de exceso de líquido y las variables sociodemográficas y clínicas. Conclusión: las características definitorias y los factores relacionados de exceso de volumen líquido podrían estar influenciados por variables sociodemográficas y clínicas en clientes de hemodiálisis.

Senile cataract patients; serum electrolytes and calcium

Purpose: The current study was aimed at finding out the significance of serum electrolytes and serum calcium levels in the development of senile cataract

Study Design: Case control study

Setting: Ghurki Trust Teaching Hospital, Lahore, Pakistan

Period: Jan 2013 to June 2013

Methods: Total fifty patients with senile cataract and fifty controls were selected. Clinical history and clinical diagnostic tests were performed by an ophthalmologist. Blood samples were drawn and serum stored at -20o C. Serum potassium and sodium were measured by Flame photometry. Serum chloride levels were estimated by quantitative displacement of thiocyanate by chloride. The estimation of calcium was done using photometry by CPC method. Statistical analysis was done by Statistical package for social sciences [SPSS version 16.0]. There were 31 females and 19 male [F: M = 1.63: 1] patients. In the control group, there were 32 females and 18 males [F: M = 1.77: 1]. The age was >/= 40 years in both patients and control group

Results: Nuclear cataract was the commonest. Among all the analytes, only serum calcium levels were found to be significantly lower in patients [p value less than 0.05 as compared to controls]. While difference of sodium, potassium and chloride levels between cases and controls was insignificant. [p values 0.49, 0.36, and 0.45 respectively]

Conclusions: In Pakistan, serum electrolytes in cataract patients are not significantly different from the controls while serum Calcium of cataract patients is significantly low when compared with the control group, indicating the possible role of low calcium level as a risk factor in the development of senile cataract

Effects of Cardioselective Beta Blocker Nebivolol on Different Biochemical Parameters in Essential Hypertensive Patients.

Background : Nebivolol is a third-generation highly selective b1-blocker with additional endothelial nitric oxide (NO) mediated vasodilating activity. This property may potentiate the blood pressure-lowering effect of Nebivolol. Nebivolol is also claimed to have neutral or favourable effect on carbohydrate metabolism and lipid profile. Therefore this study was conducted to evaluate effects of Nebivolol on different biochemical parameters in essential hypertensive patients. Materials and Methods : 21 newly diagnosed patients of either sex with essential hypertension were included in the study. Patients having co-morbidities e.g. Diabetes mellitus, hyperlipidemia, gout, pregnant females were excluded from the study. Baseline readings of lipid profile, serum electrolytes, fasting blood sugar and uric acid were recorded before starting Nebivolol drug therapy. Same biochemical tests were repeated after six months drug treatment. Results and Observation : After comparing the means there is increase in total cholesterol, LDL, Serum electrolytes, blood sugar levels but this increase is within normal limits and is not statistically significant. While there is decrease in TG level but statistically not significant. No significant change in HDL, uric acid levels. Conclusion : Nebivolol is a unique, highly selective b1-blocker due to its neutral metabolic properties and is potentially safe over conventional b-blockers.

Electrolyte Imbalance in Cataract Patients.

100 cataract patients of IGGMC attending Biochemistry OPD for routine Blood sugar, were estimated for serum electrolyte level i.e. Sodium, Potassium level and compared with normal healthy age related ( 50-70 yrs) control by t test. Plasma Glucose level (to rule out Diabetes) and serum Creatinine (to rule out renal disorder) in both cases and control were also studied. Result of our study shows Elevation in serum Na level in cataract pts mean 148.52 + /-4.13 meq/lt compared to control mean 139.26 +/-3.08 meq/lt (p value 0.001) which is significantly high. Normal Serum Na level is required to maintain proper water electrolyte balance across lens membrane that in turn is also responsible for maintaining lens membrane permeability. Elevation in serum Na level in cataract pts may result into its further increase in aqueous humor of lens which may lead to osmotic imbalance across lens membrane and aggravate, progression of disease. We conclude that salt restricted Diet must be advised in Cataract patients so as to maintain normal electrolyte balance which may prevent further progression of disease.

Serum lipids, proteins and electrolyte profiles in rats following total body irradiation / Perfiles de lípidos, proteínas y electrolitos plasmáticos en ratas tras irradiación corporal total

OBJECTIVE: Serum lipid and electrolyte imbalances are common in critically ill patients undergoing radiation therapy. Although multiple disease states and medication may be responsible for the development of these disorders, the aim of this research is to sequentially document the effect of total body radiation on body function utilizing the sequential changes in the serum lipids, electrolytes and protein in rats. METHODS: Serum protein and lipids contents were assessed using kits while electrolytes were assessed with flame photometry in rats exposed to total body irradiations of 1.27 Gy/min in cumulative doses to the fourth irradiation at five-day intervals. RESULTS: Total cholesterol and triacylglycerols serum levels were significantly reduced by irradiation (p < 0.05). No significant differences between experimental and control groups for HDL-C serum levels were detected. Serum electrolyte concentration remained within the normal range after each total body irradiation. Sodium, bicarbonate and chloride were significantly (p < 0.05) higher than control while potassium and creatinine were significantly reduced after the first irradiation only. Sodium/potassium ratio was significantly (p < 0.05) elevated. Serum protein was significantly (p < 0.05) elevated with increasing radiation. CONCLUSION: There are subtle but significant changes in serum lipids, electrolytes and protein after total body irradiation of normal rats. These variations could be due to non-specific stress reactions; as such, they are important markers in radiation induced injury diagnosis.

OBJETIVO: Los desequilibrios de lípido y electrolito plasmáticos son comunes en los pacientes críticos sometidos a terapia radioactiva. Aunque los múltiples estados de la enfermedad y la medicación pueden ser responsables del surgimiento de estos trastornos, el objetivo de esta investigación es documentar de manera secuencial el efecto de la radiación corporal total sobre la función corporal, utilizando los cambios secuenciales en los lípidos, electrolitos y proteínas plasmáticos en las ratas. MÉTODOS: Los contenidos de lípidos y proteínas plasmáticos fueron evaluados utilizando kits, en tanto que los electrolitos fueron evaluados mediante fotometría de llama en ratas expuestas a irradiaciones corporales totales de rayos X de 1.27 Gy/min, en dosis cumulativas hasta la cuarta irradiación en intervalos de cinco días. RESULTADOS: El colesterol total y los niveles plasmáticos de triacilgliceroles fueron reducidos significativamente por la irradiación (p < 0.05). No se detectaron diferencias significativas entre; os grupos experimentales y de control en relación con los niveles plasmáticos de colesterol HDL. La concen-tración de electrolito plasmático se mantuvo dentro de los límites normales luego de cada irradiación corporal total de rayos X. La relación sodio/potasio fue significativamente elevada (p < 0.05). La proteína plasmática se elevaba significativamente (p < 0.05) al aumentar la radiación. CONCLUSIÓN: Tras la irradiación corporal total de las ratas normales, seproducen cambios sutiles pero significativos en los lípidos, electrolitos y proteínas del plasma. Estas variaciones podrían ser debidas a reacciones de estrés no específicas, y como tal, son marcadores importantes en el diagnóstico de las lesiones inducidas por la radiación.

[Blood serum electrolyte and non-electrolyte parameters in breeding rutilus frisiikutum kammensky]

Reference values of serum parameters are important markers in health evaluation and diagnosis of diseases, as well as in controlling biological processes in aquatic animals. The aim of this research was to determine the reference values of biochemical factors in breeding Rutilus frisii kutum. Blood samples were collected from captured fish from Tajan River. Serum levels of glucose, BUN, creatinine, cholesterol, triglyceride, direct bilirubin, total protein, albumin, calcium [Ca], phosphorus [P], sodium [Na], and potassium [K] were measured. The serum levels of different biochemical values in males and females were as follows: Na for males 387.1 +/- 11.5, and females 420.7 +/- 7.1; K for males 39.9 +/- 10.6, and for females 37.9 +/- 7.4; P for males 19.2 +/- 1.0, and females 28.9 +/- 2.8; Ca for males 15.9 +/- 1.5, and for females 21.6 +/- 1.0; glucose for males 209.8 +/- 23.2, and for females 83.8 +/- 11.3; cholesterol for males, 472.6 +/- 23.6, and for females 306.6 +/- 22.9; triglyceride for males 393 +/- 23.3, and for females 275.1 +/- 9.2; total bilirubin for males 0.4 +/- 0.02, and for females 0.3 +/- 0.02; direct bilirubin for males 0.1 +/- 0.03, and for females 0.1 +/- 0.02; BUN for males 22.3 +/- 1.0, and for females 24.1 +/- 1.1; creatinine for males 0.5 +/- 0.1, and for females 0.7 +/- 0.1 [mg/dl]; total protein for males 5.8 +/- 0.5, and for females 4.4 +/- 0.5; albumin for males 3.3 +/- 0.2, and for females 3.0 +/- 0.2 [g/dl]. The current results indicate that there are significant differences in serum values of glucose, cholesterol, total bilirubin, direct bilirubin, triglyceride, phosphorus, sodium and calcium between males and females. The serum levels of cholesterol, triglyceride [p<0.001], glucose, total bilirubin [p<0.01] and direct bilirubin [p<0.05] in males, and those of phosphorus, calcium [p<0.01] and sodium [p<0.05] in females were significantly higher as compared to the opposite sexes. It can be concluded that the studied parameters may be affected by physiological factors such as the sex of fish

Study the effect of antiepileptic drugs on some trace elements and electrolytes in a group of Egyptian children attending the paediatric outpatientclinic in El Sahel Teaching Hospital

Epileptic patients exhibited variably altered status of trace elements and electrolytes. The present study was an attempt to find out the relation between level of some trace elements [zinc and copper], electrolytes [calcium, magnesium, sodium and potassium], liver function tests and kidney function tests in epileptic children as well as the effect of the antiepileptic therapy on their levels. Cross sectional case control study was carried out on 60 epileptic children randomly chosen from the paediatric clinic in El Sahel Teaching Hospital, aged 4-14 years [35 males, 25 females], 15 cases prior to therapy, 45 cases under AET in the form of Carbamezepine [CBZ], Sodium valproate [VPA] and polytherapy [PT] The control group consisted of 20 healthy children without seizure. Zn2+ and Cu 2+ in serum were analyzed by direct calorimetric spectrophotometer, while Ca[2]+, Mg[2]+, Na+ and K+ in serum were analyzed by automated autoanalyser. Serum Zn2 and Na+ levels were significantly increased in both untreated and treated groups than control, while serum Cu[2]+ level was significantly decreased in untreated group and treated groups than in control, while serum K+ level was significantly decreased in untreated group. No difference was observed in the levels of Ca[2]+ and Mg[2]+ in all studied groups. Trace elements [Zn[2]+ and Cu[2]+ and minerals [Ca[2]+, Mg[2]+, Na+ and K>] are significantly altered with epilepsy, with further alteration after therapy, being a cause or a result. We are waiting for further elucidation

Acute myocardial ihfarction; serum magnesium and electrolyte levels at presentation in emergency department

Magnesium, the second most abundant intracellular cation have several critically important roles in human body. In addition to energy production and maintenance of electrolyte balance, magnesium [Mg[++] is essential for normal neuromuscular function, excitation contraction coupling maintenance of vessel tone, blood coagulation as well as Ca[++] and K[+] transport across the plasma membrane. Case control study. Atotal of 125 subjects enrolled for this study, 88 were AMI patients having their first episode. 37 subjects were taken as control group. These patients were classified into three groups depending on the age of the subjects. To find out serum magnesium and electrolyte levels in AMI patients at presentation to Emergency Department. Hypomagnesaemia is a common clinical finding in cases of acute myocardial infarction at their presentation to the emergency department of Punjab Institute of Cardiology, Lahore. It is very critical as ventricular tachyarrythmias cardiac arrest, sudden cardiac death, re-infarction are the usual outcome. There is Hypomagnessemia [P<0.001] in all the subgroups while for Na[+] and K[+] [P>0.05]. Our result explains the contribution of hypomagnesaemia as a minor risk factor for AMI. Therefore it is suggested that serum magnesium should be estimated in each case of AMI patient. Importance may be given to Mg[++] supplementation where needed. The dosage should not be empirical but be based on individual patient requirement

[Survey of polyethylene glycol effects on serum electrolytes]

Colonoscopy and bowel preparation caused a number of serum electrolytes changes that may be dangerous in heart and kidney diseases and elderly patients. To determine the effect of serum electrolytes in patients who underwent colonoscopy and bowel preparation with PEG [Polyethylene Glycol] in Tehran Imam Khomeini hospital in 2008. Fifty nine patients who had been selected for elective colonoscopy after the detection of exclusion criteria were assessed prospectively. Serum level of sodium and potassium were analysed before bowel preparation with PEG [T[0], before colonoscopy T[1] and immediately after it T[2]. Serum calcium and phosphorus levels were measured just before and after PEG. Four patients [6.8%] did not follow the research protocol and were excluded. Four patients [6.8%] developed hyponatremia in T[1] that continued in T[2]. There were no significant differences in prevalence of Hyponatremia and means of sodium serum levels in T[0], T[1] and T[2]. Although there was a significant trend to decreased means of potassium levels of T[2] versus T[1] [P<0.01], but the maximum prevalence of Hypakalemia was in T[1] [10.9%] with only 3.8% new Hypokaliemia in T[2] and there was no significant difference. The prevalence of Hypocalcemia after PEG was 24% but there was no significant decrease. 36% of patients developed Hypophosphatemia after PEG preparation with a significant decrease in mean of serum Phosphorus level [P<0.05]. There was no significant relationship between electrolytes changes with age and sex. The serum electrolyte changes showed that preparation with PEG is a risk factor for development of Hypophosphatemia Colonoscopy and preparation with PEG may cause a significant decrease in potassium serum level

Evaluation of serum electrolytes and uric acid in Iraqi epileptic patients

Epileptic patients exhibited variably altered status of electrolytes, and antioxidant. The aim of this study is to investigate the effect of epilepsy and long-term antiepileptic drug therapy on the level of serum electrolytes [calcium, sodium, and potassium] and antioxidant [uric acid] .Thirty epileptic patients and twenty normal healthy individuals as a control were recruited in this study. The mean +/- SD of age of treated and untreated patients was [24.0 +/- 10.0] and [31.0 +/- 11.0] respectively. Spectrophotometric technique was used to determine all the parameters in this study. Data were expressed as mean +/- SD. Statistical comparison among different groups was performed by using ANOVA tests. Statistical significance was defined, as P<0.05. The treated group [particularly with valproate], show increases in the levels of calcium, sodium, with no difference in potassium, however among untreated epileptics, uric acid level was increased. The above parameters differs in epileptics comparable to controls and hence their correlation to seizures pathophysiology and their degree of control or resistance to antiepileptic drug therapy

Clinical profile and outcome of diabetic ketoacidosis in children.

Background. There is little information on the clinical profile and outcome of children with diabetic ketoacidosis in India. We analysed the data of children managed by us at a tertiary care hospital. Methods. We retrospectively analysed the case records of 21 children (13 boys and 8 girls) with diabetic ketoacidosis admitted to our hospital from January 2004 to August 2008. They were managed using a standard protocol including intravenous fluids and insulin infusion. Blood glucose, serum electrolytes, blood urea, arterial blood gases and urinary ketones were monitored at regular intervals. The outcomes were assessed. Results. The median age at presentation was 8 years and 17 children (80%) were detected to have diabetes mellitus at the time of presentation. Twelve children (57%) presented with severe diabetic ketoacidosis. Polyuria with polydipsia was the commonest clinical presentation (17). All of them had elevated HbA1C levels. The average length of stay in the paediatric intensive care unit was 2.9 days. The median time for the arterial blood gases to become normal was 19 hours and for urinary ketones to become non-detectable was 28 hours. None of the children received bicarbonate and there were no complications or mortality. All the children were doing well on follow up at 3 months. Conclusion. The outcome of active management of diabetic ketoacidosis in children is rewarding. The use of a standard protocol for management was associated with no complications or mortality in our series.

Cardio-renal effects of celecoxib versus ibuprofen in patients with arthritis

Arthritis is a common condition that co-exists in the elderly population. This condition leads to frequent administration of co-morbid Non Steroidal Anti-inflammatory drugs [NSAIDs]. To study cardio-renal toxicity of celecoxib versus ibuprofen in arthritic patients. Seven hundred ninety two arthritic patients were enrolled in the study for 6 months. Three hundred ninty six patients administered celecoxib, 400 mg twice a day; 396 patients administered ibuprofen 300 mg three times a day Effects measured included: investigator reported hypertension, edema, or congestive heart failure, and increases in serum creatinine or reduction in serum creatinine clearance, and changes in serum electrolytes. Celecoxib was associated with significant [P<0.05] lower incidence of hypertension and edema in comparison with ibuprofen. Systolic hypertension occurred significantly less [P<0.05] with celecoxib compared with ibuprofen. Serum creatinine was significantly increased [P<0.05] in patients treated with ibuprofen in comparison with celecoxib. Creatinine clearance was significantly lower [P<0.05] in cases treated with ibuprofen in comparison to celecoxib. Non significant changes in serum body electrolytes. The most important finding of this study was the lowering incidence of cardiorenal complications of celecoxib in comparison with ibuprofen

[ impact of chronic hemodialysis on QT dispersion, corrected QT dispersion and maximum QT-dispersion]

Sudden cardiac death is common in patients on hemodialysis and may occur in the immediate postdialysis period when ventricular premature complexes are common. QT dispersion, reflecting hetovogelity in ventricle repolarization, has been used for predicting patients with risk of malignant arrhythmia and sudden death. The purpose of the study was to assess the effect of hemodialysis on QT dispersion [QTd], corrected QT dispersion [QTcd] and maximum QTc [QTcMax] in chronic hemodialysis patients. In this descriptive-analytic study, data of 48 patients [30 male and 18 female patients with mean age, 43 +/- 16 yr] on chronic hemodialysis were studied. 12 lead ECG were recorded 5-10 minutes before and after hemodialysis in a standard setting and Na +, K+, Ca+ +, Po4 and Mg++ levels were also determined pre and post hemodialysis. During hemodialysis, no drug therapy was used except isotonic and hypertonic NaCl influsions and sodium heparin. The maintenance drug therapy including digitalis, antihypertensive, antianginal, and beta blocking agents was not changed. The data were analyzed using SPSS software. The maximal QTd interval changed significantly from 434 +/- 12.8 ms to 443 +/- 21.33 ms [P<0.001]. The QTd increased significantly from 55.87 +/- 7.5 ms to 61.27 +/- 9.09 ms [P<0.001] and QTcd from 61.18 +/- 7.43ms to 68.79 +/- 10.32ms [P<0.001]. 33.33% of the patients before and 47.90% after hemodialysis had QTcMax more than 440 ms. Hemodialysis increases the QTd, QTcd and QTcMax in patients with end-stage renal failure. Thus it is likely that heterogeneity of regional ventricular repolarization increases during hemodialysis

Urinary sodium and potassium excretion following karate competitions

Exercise induces renal hemodynamic alterations and stimulates electrolytes excretion. The purpose of this study was to assess urinary excretion of sodium and potassium in karate practitioners, following competitions. The study population composed of 18 healthy men, aged 18 to 21 years, with similar physical characteristics. They were professional karatekas with a history of at least 7 years of karate training. The participants competed in 3 rounds of about 3 minutes in duration with 10 minutes resting intervals between them. The 24-hour urine samples were collected before [while trainings were stopped] and after the match and their sodium and potassium concentrations were measured. Also, blood samples were obtained before and after the match for measurement of these electrolytes in the participants' sera. Before the match, the mean values of urinary sodium and potassium were 200.3 +/- 89.3 mEq/L/d and 68.5 +/- 12.9 mEq/L/d, respectively. After the match, they changed into 206.9 +/- 74.7 mEq/L/d and 67.1 +/- 14.4 mEq/L/d, respectively. No significant alterations were observed in urinary sodium and potassium excretion following karate match [P = .94 and P = .96, respectively]. Serum sodium levels were 136.7 +/- 3.1 mEq/L and 136.3 +/- 2.9 mEq/L, before and after the match, respectively [P = .11], serum potassium levels were 4.2 +/- 0.3 mEq/L and 4.1 +/- 0.2 mEq/L, respectively [P = .16]. With regard to short duration and anaerobic nature of karate, it seems that a Karate match does not contribute to excessive urinary electrolytes excretion

Hemodynamics alterations during orthotopic liver experimental transplantation in pigs

PURPOSE: To describe the hemodynamics alterations during orthotopic liver transplantation in pigs. METHODS: In the period from April 2004 to December 2005, forty-four female Landrace pigs, weighting between 32 and 38 Kg were undergone to orthotopic liver transplantation. The animals were divided into two groups, donor and recipient pairs, which received whole liver grafts. The surgical procedure was divided into four parts: harvested, back-table, hepatectomy of the recipient and implantation. We analyze heart rate, blood gas, mean systemic arterial pressure (MAP-mmHg), central venous pressure, pH, Na-, K+, Cl-, Ca+ and urinary output. RESULTS: The mean anhepatic time was 69 min, cold ischemia was 252.2 min and back-table was 56.6 min. Blood pressure and heart rate dropped significantly during anhepatic phase and after revascularization. Blood gas and electrolytes alterations were observed during anhepatic and reperfusion phases. Although alterations were noted during these phases, the hemodynamic status was recovered and stabilized in the end of the surgery. CONCLUSIONS: Simplified technique of liver transplant was achieved and description of hemodynamic alterations was possible in pigs.

OBJETIVO: Descrever as alterações hemodinâmicas que ocorrem durante o transplante hepático ortotópico experimental em suínos. MÉTODOS: No período de abril de 2004 a dezembro de 2005, quarenta porcos da raça Landrace, fêmeas, pesando entre 32 e 38Kg foram submetidos a transplante hepático ortotópico. Os animais foram divididos em dois grupos, doador e receptor, estes receberam enxerto total. O procedimento cirúrgico foi dividido em captação, cirurgia de banco, hepatectomia do receptor e implante do enxerto. Analisamos a freqüência cardíaca, gasometria, pressão arterial média (PAM-mmHg), pressão venosa central, pH, Na-, K+, Cl-, Ca+, e débito urinário. RESULTADOS: O tempo médio de fase anepática foi de 69 minutos, tempo de isquemia fria foi de 252,2 minutos e cirurgia de banco de 56,6 minutos. A pressão sanguínea caiu significativamente e a freqüência cardíaca elevou-se durante a fase anepática e de revascularização. As alterações na gasometria e eletrólitos foram observadas durante as fases anepática e de revascularização. Embora estas alterações tenham sido observadas durante aquelas fases, o padrão hemodinâmico foi recuperado e estabilizado no final da operação. CONCLUSÕES: Uma técnica simplificada de transplante hepático experimental teve seu objetivo alcançado e foi possível identificar corrigir as alterações hemodinâmicas encontradas em suínos.

Comparison of some electrolytes in hydatid cyst fluid and serum of liver hydatidosis of sheep

In this study, we collected 100 samples of liver hydatid cyst and blood of infected sheep from the Ahvaz abattoir. The existing Ca, P, Mg, Na and K were measured by an auto analyzer apparatus. The result of T. student test showed that there are a significant difference between serum and fluid of cyst in all electrolytes [p<0.05]. There was also a significant difference between these electrolytes in infected sheep and normal sheep [p<0.05]. These results confirmed that the entrance of essential electrolytes have depended on selective permeability and parasite requirement. Ca and P have vital roles in the prevention of hydatid cyst fluid acidity. Understanding parasite nutrition behavior would help us to conduct a better drug treatment in inoperative cyst via selection of effective drug and adherence of this drug to biological material that promote distribution of drug to the cyst

Changes in serum electrolytes and lipid profile in diabetes subjects in freetown Sierra Leone

Measurement of blood electrolytes level and lipid profile usually give good indications of the disease progression in a number of non communicable diseases. To investigate the effect of diabetes on electrolyte and lipid status of male and female diabetics in Freetown, Sierra Leone. Subjects and Serum concentrations of electrolytes and lipids in one hundred and twenty [120] adult diabetics attending some diagnostic centers in Freetown Sierra Leone were measured and compared with those of one hundred and twenty [120] non-diabetic individuals. Total cholesterol, LDL-cholesterol, triglycerides and coronary heart disease [CHD] risk ratio in diabetic patients were significantly higher [P<0.05] than those of non-diabetics. Diabetic subjects also have low HDL-cholesterol compared with the non-diabetics. Analysis of serum electrolytes in diabetic individuals also shows significant reduction in serum K[+], Na[+] and HCO[3] while Cl[-] was significantly elevated compared with non-diabetics. There was no significant difference between the sexes in all parameters studied. We conclude that lipid abnormalities and electrolyte imbalance contribute towards complications observed in diabetes

Management of simple febrile seizures; A study conducted in Imam Hospital, Oromieh

Different medical and rehabilitation interventions have been used for treatment of cerebral palsy [CP]. In addition to conventional methods, complementary medicine such as homeopathy has been used in treatment of neurodevelopmental disorders. This study has been done to determine what effect homeopathic treatment would have on motor development [MD] of children with spastic CP, when added to rehabilitation normally used for such children. This 2004 study was a double blind clinical trial, conducted on twenty-four subjects recruited from a developmental disorders clinic in Tehran. Using the minimization technique, subjects were divided to the case and control groups. Routine rehabilitation techniques were carried out for 4 months on both groups. In addition the cases were given homeopathy drugs, while the controls received placebos. Levels of gross and fine motor development were assessed with the Denver Developmental Screening Test II [DDST II]. Data was collected by assessment forms, direct observations and examinations. Dependant variables in the two groups were compared at the beginning and at the end of the study. The average ages of the case and control groups were 28 and 28.4 months respectively. Gross and fine motor development and motor developmental quotient in the case group, compared to the controls showed no statistically significant differences. Based on the results of this study adding homeopathy to rehabilitation had no significant effect on motor development of CP children. Considering the documented effects of homeopathy on the physical status of children with CP it would be better not to reject the possibility of effects of homeopathy on motor development of children with CP. As homeopathy is young in Iran, it is recommended to conduct further more extensive research on the effects of homeopathy on neurodevelopmental diseases

Effect of amoebiasis on serum electrolytes in children diarrhea

This study has been performed on 54 patients with Amoebiasis after they head diagnosed by microscopic examination and we have ignore other causes ofdiarrhea. The aim of this work is to study the effect ofdiarrhea caused by Amoebiasis in children on some of biochemical variables. The patients were divided into three groups according to the age, the control consist of 22 children with out Amoebiasis [healthy child]. The results of each age group of patients were compared with the same age group of the control, also the results indicated that the level of serum total, direct and indirect bilirubin in patients with Amoebiasis was significantly higher than that for control for each age group. The results indicated that the level of serum sodium, potassium, chloride, calcium and phosphorous of the patients was significantly lower than that for control in each age group. This study indicates that the diarrhea caused by Amoebiasis affected some of the liver and the intestine functions, which leaded to some biochemical changes in serum